Arizona department of environmental quality

«Applicant»

«Street_or_P_O_Box»

«City», «State» «Zip_code»

b. Fire must be extinguished two hours before sunset.

ALL PLASTIC MATERIALS:	Bottles for household chemical; grocery and retail bags
TOXIC VEGETATIVE MATERIALS:	Oleander, poison oak, poison ivy, poison sumac
WASTE PETROLEUM PRODUCTS:	Waste crankcase oil, transmission oil, used oil, oil filters
CONSTRUCTION MATERIAL:	Chemically treated wood, lead-painted wood, linoleum flooring, composite counter tops, asphalt shingles, tar paper, electrical wire insulation, asbestos, thermal insulation.
HAZARDOUS WASTE PRODUCTS:	Paints, pesticides, cleaners and solvents, stains and varnishes, flammable liquids, plastic pesticide bags and containers
HAZARDOUS MATERIAL CONTAINERS THAT CONTAINED:	Lead compounds, cadmium compounds, mercury, arsenic compounds.
PLASTIC AND RUBBER PRODUCTS INCLUDING:	Bottles for household cleaning, plastic grocery and retail bags
AUTOMOTIVE WASTE :	Tires, anti freeze
POLYESTER PRODUCTS
AEROSOL SPRAY CANS
BATTERIES:
FLAMMABLE LIQUIDS
EXPLOSIVES OR AMMUNITION
NON PAPER FOOD GARBAGE

1. 
   Minimize the material to be burned;
   

2. 
   Prevent fire from spreading by lining the area where open burn is conducted and application of fire retardant foam, or water;
   

3. 
   Allow the material to dry before burning;
   

4. 
   Minimize soil content in slash piles and by constructing piles under dry soil conditions or by using hand piling methods;
   

5. 
   Burn in piles;
   

6. 
   Use a back fire (burn in the opposite direction of wind) when grass is burned;
   

7. 
   Extinguish the smoldering burns;
   

8. 
   Burn before litter falls;
   

9. 
   Burn prior to precipitation.
   

1. 
   The material to be burned shall be dry, readily combustible, and placed in the following arrangement(s) in such quantities that it will be completely consumed within the permitted burn hours in Condition 2 above:
   

1. 
   Piled [ «Pile» ]
   
2. 
   Collected in a pit [ «Pit» ]
   
3. 
   Placed in an approved waste burner [ «App_Waste_Burner» ]
   
4. 
   Ignite in place (field burning) [ «Ignited_in_Place» ]
   
5. 
   Ditch Burning [ «Ditch_Burning» ]
   

b. The piled, pit-contained material or approved waste burner must have a minimum clearance of 50 feet from any structure. [A.A.C.R18-2-602.D.3.k]

1. 
   The Permittee must notify the nearest fire fighting agency or private fire protection service provider, if the service provider is a delegated authority, prior to each open burning. The agency may require the Permittee to obtain a permit from them before being allowed to burn and may prohibit open burning during periods of smoke dispersion, excessive visibility impairment, or during periods of extreme fire danger. In the case that there is no fire fighting agency for the area where the burn will be conducted, the Permittee shall contact the State Forester. [A.A.C.R18-2-602.D.3.g]
   

2. 
   The Permittee shall not open burn when any air stagnation advisory, as issued by the National Weather Service, is in effect in the area of the burn or during periods when smoke can be expected to accumulate to the extent that it will significantly impair visibility in Class I areas. [A.A.C.R18-2-602.D.3.m]
   

c. The Permittee shall not open burn when any stage air pollution episode is declared under R18-2-220, Air Pollution Emergency Episodes. [A.A.C.R18-2-602.D.3.n]

[A.A.C.R18-2-602.D.3.i]

[A.A.C.R18-2-602.D.3.j]

2. 
   This section does not apply to any of the following:
   

1. Open burning that is lawfully conducted in the course of agricultural operations.

2. 
   Fire management operations that are conducted by a political subdivision.
   

2. 
   Prescribed or controlled burns that are conducted with written authority from the state forester.
   

2. 
   Lawful activities that are conducted pursuant to any rule, regulation or policy that is adopted by a state, tribal or federal agency.
   

2. 
   In absence of a fire ban or other burn restrictions to a person on public lands, setting a fire for purposes of cooking or warming that does not spread sufficiently from its source to require action by a fire control agency.
   

C. A person who violates this section is guilty of an offense as follows:

2. 
   If done recklessly, the offense is a class I misdemeanor;
   

2. 
   If done intentionally or knowingly and the person knows or reasonably should know that the person's conduct violates any order or rule that is issued by a governmental entity and that prohibits, bans, restricts or otherwise regulates fires during periods of extreme fire hazard, the offense is a class 6 felony.
   

2. 
   If done intentionally and the person's conduct places another person in danger of death or serious bodily injury or places any building or occupied structure of another person in danger of damage, the offense is a class 3 felony.
   

Eric C. Massey Date: «Issue_Date»

Director, Air Quality Division Engineer: «Engineer»

Arizona Department of Environmental Quality

(602) 771-2308

Name of the Permittee: «Applicant»

Please mail this form to the permit issuing agency (ADEQ or delegated fire department)

I certify that I have knowledge of the facts herein set forth, and in this report that the same are true, accurate, and complete to the best of my knowledge and belief. I acknowledge that all information not identified by me as confidential shall be treated by the Arizona Department of Environmental Quality as a public record.

Name (Print/Type):

(Signature): Date:

Name (Print/Type):